Prognostic Factors for Neovascular Glaucoma after Vitrectomy in Eyes with Proliferative Diabetic Retinopathy

PURPOSE: To investigate the prognostic factors for neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy. METHODS: In the present study we retrospectively reviewed intraindividual and interocular differences in 14 patients (28 eyes) who underwent pars plana vitrectomy for proliferative retinopathy with vitreous hemorrhage and having only 1 eye neovascular glaucoma. The patients underwent vitrectomy between March 2008 and July 2014 at Maryknoll Hospital. The patient clinical data on preoperative, intraoperative and postoperative factors were compared. Statistical analysis was performed using the Wilcoxon matched-pairs signed-rank (Mann-Whitney) test and chi-square test to evaluate the significance of differences within the patient groups. RESULTS: The decrease of photopic b-wave amplitudes on the preoperative electroretinogram significantly correlated with the development of neovascular glaucoma after vitrectomy for proliferative retinopathy with vitreous hemorrhage (p > 0.05). CONCLUSIONS: Based on the results from the present study, decreased photopic b-wave amplitudes on preoperative electroretinogram is an effective prognostic factor for the development of neovascular glaucoma after vitrectomy for proliferative retinopathy with vitreous hemorrhage.

Risk Factors for Development of Posterior Capsule Opacification after Cataract Surgery or Combined Vitreoretinal Surgery

PURPOSE: To evaluate the risk factors for the development of posterior capsule opacification (PCO) after cataract surgery or combined cataract and vitreoretinal surgery. METHODS: In the present study all surgical procedures were performed by the same surgeon. We retrospectively reviewed 272 consecutive eyes that received cataract surgery or combined cataract and vitreoretinal surgery. The risk factors including gender, age, diabetes, continuous curvilinear capsulorhexis (CCC) size, intraocular lens shape, intraoperative intravitreal bevacizumab, gas, and silicone oil injections were evaluated using multiple logistic regression analysis. RESULTS: PCO developed in 55 (20.2%) out of 272 eyes. The mean age was 63.3 +/- 12.1 years (range 23-85 years) and mean follow-up period was 17.3 +/- 3 months. A correlation existed between the development of the PCO and age (p 0.05). CONCLUSIONS: The risk factors associated with PCO included young age, large CCC size, combined cataract and vitreoretinal surgery, intraoperative intravitreal gas and silicone oil injections.

A Case of Sphenoidal Sinus Carcinoma Associated with Partial Oculomotor and Abducens Nerve Palsy

PURPOSE: To report a rare case of a patient with diplopia due to a mass in the sphenoidal sinus, histologically diagnosed as carcinoma. CASE SUMMARY: A 57-year-old male visited our clinic complaining of diplopia and ptosis for 10 days. He had esotropia 45 prism diopters in the primary position, markedly limited abduction, and a 4 mm dilated pupil in the right eye compared with a 2 mm pupil in the left eye. Enhanced magnetic resonance imaging revealed a sphenoidal sinus mass extended into the pituitary gland and sella turcica with homogeneous intense enhancement. Metastatic workups, including CT of the head, neck, chest, and abdomen were unremarkable. He underwent a transsphenoidal approach mass debulking surgery followed by radiotherapy for 6 weeks. Histological findings were compatible with carcinoma. Six weeks after radiotherapy he had esotropia of 20 prism diopters in the primary position. Abduction limitation was partially recovered postoperatively. CONCLUSIONS: Diplopia may develop as a result of multiple cranial nerve palsy due to carcinoma in the sphenoidal sinus and may be improved by debulking surgery and radiation treatment.

A Case of Pott's Puffy Tumor from Recurrent Upper Eyelid Abscess

PURPOSE: To report a case of Pott's puffy tumor from a recurrent upper eyelid abscess. CASE SUMMARY: A 73-year-old male visited our clinic with recurrent upper eyelid abscess over the previous 3 months. The patient did not have any evidence of external injuries, systemic inflammations, or any other specific findings. The best corrected visual acuity was 0.9 in the right and 0.5 in the left eye with normal IOP. Enhanced CT revealed a focal low density mass (11.3 x 12.6 x 10 mm) with peripheral enhancement. An excisional biopsy was performed. Histopathologic examination revealed chronic inflammation and granulation tissue formation and the patient was diagnosed with Pott's puffy tumor. The patient experienced no discomfort after the excision biopsy. At the 14-month follow-up, there were no signs of recurrence. CONCLUSIONS: Although rare, Pott' puffy tumor should be considered in the differential diagnosis of upper eyelid mass.

The Changes in Tear Film after Primary Pterygium Operation

PURPOSE: In this study we evaluated the changes in tear film after primary pterygium operation in patients with pterygium. METHODS: We investigated 43 eyes of 42 subjects who showed successful results 3 months after pterygium operation performed by one surgeon. The changes in tear film thickness, tear break-up time (BUT), Schirmer I test, and ocular surface disease index (OSDI) were evaluated. All values were compared before and after surgery. RESULTS: The mean age was 58.0 +/- 11.1 years (34-81 years). Preoperative tear film thickness, tear BUT, and Schirmer I test in eyes which underwent pterygium operation were 21.53 +/- 5.93 microm, 4.84 +/- 2.21 seconds, and 11.67 +/- 6.75 mm, respectively. Three months after the operation, the respective values were 24.23 +/- 4.19 microm (p < 0.05), 5.81 +/- 1.89 seconds (p < 0.05), and 13.02 +/- 7.54 mm (p = 0.094). Tear film thickness and BUT score increased significantly after pterygium operation. There was no statistically significant difference in Schirmer I test, before and 3 months after pterygium operation. The subjective parameter (OSDI) improved 3 months after pterygium operation (p = 0.015). CONCLUSIONS: Pterygium operation can partially restore the tear film function into a normal state by improving tear film thickness and tear BUT after pterygium operation.